Postgraduate Course at DDW: Complete Clinical Updates for Today's Practice | May 2025-MANAGEMENT OF ANTICOAGULATION AND ANTIPLATELETS IN ENDOSCOPY

Video Transcription

Video Summary

Dr. Nina Abraham from the Mayo Clinic in Arizona provided a comprehensive session on managing antiplatelet and anticoagulant drugs. She emphasized the importance of assessing life-threatening hemorrhages in patients on these drugs, distinguishing between major bleeds and less severe cases. Proper management of GI bleeding, including the use of reversal agents like PCC for warfarin or other specific therapies, was highlighted. She also discussed strategies to manage antiplatelet drug-related bleeding, advocating against routine platelet transfusions due to increased mortality risks. Dr. Abraham stressed timely resumption of anticoagulants post-procedure to minimize thromboembolic risks. Key insights were given on cold snare polypectomy, emphasizing correct technique to avoid incomplete resections. For PEG procedures, new evidence supports the safety of continuing dual antiplatelet therapy. She recommended Vitron C for managing iron deficiency, underscoring the need for nutritional history-taking and addressing non-bleeding AVMs. To avoid legal pitfalls, Dr. Abraham advised against unnecessary reversal agents and routine discontinuation of cardiac aspirin, recommending multidisciplinary discussions in complex cases.

Keywords

antiplatelet management

anticoagulant drugs

hemorrhage assessment

GI bleeding

reversal agents

thromboembolic risks

cold snare polypectomy

dual antiplatelet therapy

nutritional history